Impact of metabolic syndrome on short-term outcome of carotid revascularization: a large sample size study in Chinese population

Bai, Xuesong; Feng, Yao; Wang, Tao; Xiao, Zhou; Yang, Changlin; Wang, Ya-Bing; Yang, Hua; Lu, Jie; Zhu, Feiqi; Chen, Yanfei; Gao, Peng; Yang, Renjie; Ma, Yan

doi:10.1097/cm9.0000000000001038

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…The results of our study are of even greater relevance in the context in which the rates of 30-day stroke/death after CEA in asymptomatic patients with insulin-dependent DM exceeded international vascular societies' guideline thresholds for acceptable outcomes in asymptomatic patients, especially those with anatomic high-risk criteria [ 9 ]. General metabolic syndrome was also a risk for short-term MACCEs after CEA, but not CAS, in a 2000-chinese cohort reported by Jiao et al [ 22 ]. However, it must be admitted that these data come from a retrospective, observational study, and our analysis did not differentiate between insulin-dependent diabetics and noninsulin-dependent diabetics.…”

Section: Discussionmentioning

confidence: 99%

Impact of Diabetes Mellitus on Early Clinical Outcome and Stent Restenosis after Carotid Artery Stenting

Achim

Lackó

Hüttl

et al. 2022

Journal of Diabetes Research

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Background. Diabetes mellitus is closely related to both the severity of carotid disease and its outcome after revascularization. Carotid artery stenting (CAS) has emerged as a viable alternative to surgical endarterectomy but little is known about the impact of diabetes after CAS. Methods. A consecutive cohort of 1940 patients undergoing CAS in two institutions was divided into two groups, diabetics and nondiabetics, and major cerebrovascular events (MACCEs) were analyzed at 30 days post-CAS and at 1 year follow-up. Results. There were 730 patients with diabetes, with significantly higher BMI, hypertension, chronic dialysis, and dyslipidemia frequency ( p < 0.05 ). There was no significant difference between the two groups in terms of early and late MACCEs (composite of transient ischemic attack, major stroke, myocardial infarction, and death), with an early rate of 3.5% nondiabetics vs. 5.3%, p = 0.08 and 2.4 nondiabetics vs. 2.3% diabetics, p = 0.1 at 12 months. Overall stroke/death rate in the asymptomatic patients was 2.4%, and the restenosis rate was higher in the diabetes population (2.3% vs. 1%, p = 0.04 ). Conclusion. The presence of diabetes was associated with an acceptable increased periprocedural risk for CAS, but no further additional risk emerged during longer term follow-up. Diabetes may precipitate the rate of early in-stent restenosis.

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Section: Discussionmentioning

confidence: 99%

Impact of Diabetes Mellitus on Early Clinical Outcome and Stent Restenosis after Carotid Artery Stenting

Achim

Lackó

Hüttl

et al. 2022

Journal of Diabetes Research

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“…Among the few MS diagnostic criteria commonly used internationally are stricter criteria for blood pressure and blood sugar, and the use of waist circumference instead of BMI. The circulatory system of the whole body is a whole, and the damage to blood vessels caused by MS is widespread [11,12]. At present, there are no su cient clinical trials to provide evidence for whether routine screening of intracranial blood vessels, neck blood vessels, coronary arteries and blood vessels of both lower limbs is necessary.…”

Section: Discussionmentioning

confidence: 99%

HDL can predict the treatment of hypotension after CAS surgery for initial internal carotid artery stenosis

Ma,

Yang,

et al. 2024

Preprint

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Background Ischemic stroke ranks at the forefront of the global spectrum of causes of death. Internal carotid artery stenosis is one of the causes of ischemic stroke, and CAS is an important method to treat internal carotid artery stenosis. However, postoperative hypotension and other complications can lead to serious neurological defects. Methods The clinical data and imaging data of patients with internal carotid artery stenosis treated by stenting in the Department of Neurology of the Second Affiliated Hospital of Xinjiang Medical University from January 2021 to December 2023 were collected for statistical analysis. Results A total of 23 patients were enrolled, 87% were male, the median age of onset was 65 years (IQR, 57-71 years), 56.2% had a history of smoking, 82.6% had hypertension, 78.9% had poor blood pressure control, 47.8% had a chronic disease, 81.8% of whom were hypertensive. Before admission, 74% of the patients had transient or persistent neurological impairment, that is TIA or IS at any stage. Of the 46 internal carotid arteries in 23 patients, 25 (54.3%) had severe stenosis, 60.9% had bilateral stenosis, and 85.7% mainly had bi-focal or severe and moderate stenosis on one side. 60.9% developed postoperative hypotension, of which 57.1% were treated with vasoactive drugs. Only HDL levels were different in the three groups with normal blood pressure, rehydration after hypotension, and medication after hypotension. Conclusions HDL level does not predict whether blood pressure will decrease after surgery, but if carotid sinus response occurs, high HDL (≧1.0mmol/L) may be more likely to require vasopressor therapy while low HDL (<1.0mmol/L) can be treated with fluid rehydration.

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“…In the control group, the rs2479409 was associated with a lower risk of metabolic syndrome, a low risk of having increased alkaline phosphatase >p75, and a low risk of increased gamma-glutamyltranspeptidase. Several reports have shown that metabolic syndrome increases the risk of cardiovascular events [ 45 , 46 , 47 ]. Recent studies have suggested that an increased serum alkaline phosphatase is a predictor of cardiovascular disease and vascular calcification [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

Variants of PCSK9 Gene Are Associated with Subclinical Atherosclerosis and Cardiometabolic Parameters in Mexicans. The GEA Project

et al. 2021

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Background: Coronary artery disease (CAD) is a chronic, inflammatory, and complex disease associated with vascular risk factors. Nowadays, the coronary artery calcium (CAC) is a specific marker of the presence and extent of atherosclerosis. Additionally, CAC is a predictor of future coronary events in asymptomatic individuals diagnosed with subclinical atherosclerosis (CAC > 0). In this study, our aim is to evaluate the participation of two polymorphisms of the PCSK9 gene as genetic markers for developing subclinical atherosclerosis and cardiometabolic risk factors in asymptomatic individuals. Methods: We analyzed two PCSK9 polymorphisms (rs2479409 and rs615563) in 394 individuals with subclinical atherosclerosis and 1102 healthy controls using real time- polymerase chain reaction (PCR). Results: Under various inheritance models adjusted for different confounding factors, the rs2479409 polymorphism was associated with an increased risk of developing subclinical atherosclerosis (OR = 1.53, P recessive = 0.041). Both polymorphisms were significantly associated with several cardiometabolic parameters. Conclusions: Our data suggest that rs2479409 polymorphism could be envisaged as a risk marker for subclinical atherosclerosis.

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Impact of metabolic syndrome on short-term outcome of carotid revascularization: a large sample size study in Chinese population

Cited by 3 publications

References 35 publications

Impact of Diabetes Mellitus on Early Clinical Outcome and Stent Restenosis after Carotid Artery Stenting

Impact of Diabetes Mellitus on Early Clinical Outcome and Stent Restenosis after Carotid Artery Stenting

HDL can predict the treatment of hypotension after CAS surgery for initial internal carotid artery stenosis

Variants of PCSK9 Gene Are Associated with Subclinical Atherosclerosis and Cardiometabolic Parameters in Mexicans. The GEA Project

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